Immune System Flashcards
1
Q
Network of cells, tissues, and organs that work together to protect the body from infection and disease
A
Immune system
2
Q
An unhealthy immune system can result in…
A
Localized infection, systemic infection, or disease
3
Q
What is the principle function of the immune system?
A
To eliminate infectious agents and abnormal “self” components without attacking the body’s own tissues
4
Q
True or false: All immune system responses are helpful
A
False. There may be organ or tissue transplant rejection
5
Q
An overactive/underachieving immune system can create…
A
A state of hypersensitivity, immune complex disease, auto immune disease
6
Q
What does an auto immune disease produce?
A
Auto-antibodies (instead of antibodies) that turns the body on itself
7
Q
Primary organs of the immune system
A
Bone marrow
Thymus
8
Q
Secondary organs of the immune system
A
Peyers patches
9
Q
What structure is responsible for disease prevention in the GI tract?
A
Peyer’s patches (act as surveillance system)
10
Q
What is the normal amount of Peyers patches?
A
30-40
11
Q
Peyers patches comprise ___% of the immune system
A
70%
12
Q
As we age, what happens to Peyer’s patches?
A
They atrophy
13
Q
This amount of the lymphatic system is in the intestines…
A
2/3
80% of immune system resides in the 20 foot tube from our mouth to our anus
14
Q
For every human cell, how many bacterial cells are there?
A
10
15
Q
The gut has its own nervous system, what is it called?
A
Enteric nervous system
16
Q
How does gluten cause a “leaky gut”?
A
Causes inflammation Villi become occluded Enzymes on fibers are lost Pathogens leak into body Gut becomes inflamed
17
Q
Breaking down pathogens that we are highly sensitive to cause…
A
Temperature increase
18
Q
Every degree in temperature requires ___% increase in energy to process food
A
20
19
Q
(Waist/hip ratio) where do you measure the waist
A
Level of umbilicus
20
Q
(Waist/hip ratio) Where do you measure the hip?
A
Top of inseam, inner thigh meets groin
21
Q
Optimal hip to waist ratio for women and men…
A
Women <0.8
Men <0.9
22
Q
What are the two types of immunity?
A
Innate immunity
Adaptive immunity
23
Q
Innate immunity is considered…
A
Natural or non-specific
24
Q
Adaptive immunity is considered…
A
Acquired or specific
25
When is innate immunity activated? And what kind of response is it?
Activated when surface barriers are breached.
| Rapid response
26
What kind of response is adaptive immunity?
Slower response
27
The humoral arm is active in...
Blood plasma and body tissues
28
The cell mediated arm is active in ....
Cytoplasm of infected cells
29
Does innate immunity have memory or no memory?
No memory
30
What are the goals of innate immunity?
Limit spread of infection
Eliminate invading pathogen
Mediate initiation and development of adaptive response to specific pathogen
31
True or false: Innate immunity and adaptive immunity occur separately?
False. They occur together and interact extensively
32
Does adaptive immunity have memory or no memory?
Memory and specificity
33
What are the goals of adaptive immunity?
Recognize threat
Promote effective immune response
Destroy/remove invading pathogen
Establish long term memory
34
Which immune responses (either innate or adaptive) are active or passive?
Adaptive immune responses are active or passive
35
This type of adaptive immunity is produce in individuals by administering foreign antigens
Active adaptive immunity
36
What are the two types of active adaptive immunity?
Natural and artificial
37
Natural active adaptive immunity occurs secondary to what?
Natural contact and with antigen (environmental exposure)
38
Artificial active adaptive immunity occurs in....
Inoculation of antigen (vaccine, injected)
39
The length of resistance for active adaptive immunity is?
Usually permanent, but may be temporary
40
What induces a primary immune response so that the patient produces faster and more effective secondary responses upon natural exposure to a pathogen?
Vaccination
41
This is one of the most important contributions of immunology to disease prevention
Vaccination
42
How to vaccines work?
Deliberately expose you to small, safe amts of antigens to generate immunologic memory NOT the infectious disease
43
What type of adaptive immunity occurs when the individual receives antibodies instead of making their own?
Passive adaptive immunity
44
This occurs from trans-placental (newborns) or breast milk, providing antibodies from the mother
Natural passive adaptive immunity
45
This occurs when there is inoculation of antibody or anti-toxin (immune serum globulin, blood donor)
Artificial passive adaptive immunity
46
What is the length of resistance for passive adaptive immunity?
Termporary
47
Examples of exterior defenses for innate immunity
```
Skin
Mucosa
Secretions
Nasal hair
Ear wax
```
48
Phagocytes (leukocytes) for innate immunity include:
```
Neutrophils
Monocytes/Macrophages
Eosinophils
Basophils
Mast cells
Platelets (inflammation)
```
49
Soluble mediators for innate immunity include:
Complement and IFNs
NK cells
Large granular lymphocytes
50
What are humoral (adaptive) responses mediated by? And what do they present as?
Mediated by antibodies
| Present as serum globulins
51
What are cell mediated (adaptive) responses mediated by?
T lymphocytes
52
In this immune response... antibodies are produced by plasma cells (differentiated form of B lymphocytes)
Humoral (adaptive) response
53
In this immune response, there is a secretion of cytokines, and a production of: Helper T cells, cytotoxic cells, and regulator suppressor T cells
Cell mediated immune response
54
This immune system responses has a primary and secondary (memory) antibody response
Humoral (adaptive) immune response
55
This immune system has a primary and secondary (memory) T-cell response
Cell mediated (adaptive) response
56
Any microorganism that has the capacity to cause disease, usually inhaled or ingested
Pathogen
57
Types of pathogens
```
Virus
Bacteria
Fungi
Protozoa
Parasites
Protein
```
58
The microscopic component of a pathogen that causes an immune reponse
Antigen
59
An antigen is a substance that induces the formation of antibodies because it is recognized by the immune system as what?
A threat
60
What are the two types of antigens and explain them.
Exogenous: antigens engulfed and broken down
Endogenous: in virus infected/tumor cells that actively synthesize foreign proteins
61
The ability of the pathogen to stimulate an immune response in the host (people, animals, plants)
Antigenicity
62
What does antigenicity depend on?
Site of invasion
# of pathogenic organisms
Dissemination of organisms in the body
63
Subunits of an antigen that elicit an immune response
Epitope
64
The greater the number of epitopes, ...
The greater the immune response
65
Active epitope is a immunological site that binds with what?
T cell receptor or antibody
66
What kind of shape are antibodies/immunoglobulin?
Large Y-shaped proteins
67
What the main function of the humoral immune system?
Production of antibodies
68
Antibodies are recruited by the immune system to identify and neutralize...
Harmful substances/objects
Bacteria
Viruses
69
Each antibody has a unique target, know as a _______, that is present on what?
Antigen, present on an invading organism
70
The antibody key: (3 things)
Activates compliment system
Tags pathogen for destruction by B or T cells
Neutralizes pathogen
71
All cells off the body contain specific _______ that are unique to that person
Cell surface markers
72
Where are major histocompatability complex proteins found?
On plasma membranes of cells
73
Why are cell markers important?
They allow the immune system cells to recognize and communicate with each other
74
The cells markers originally discovered on leukocytes are also called...
Human leukocyte antigens (HLA's)
75
Humans leukocyte antigens (HLAs) are:
Inherited maternal and paternal allele on surface of each cell
Predispose an individuals susceptibility to autoimmune diseases
76
Autoimmune disease examples:
RA
Graves diseases
Psoriasis
Thyroiditis
77
What is the primary role of innate immunity?
Acts as the body's first line of defense to prevent pathogens from entering
78
Four things about innate immunity:
Rapid and predictive response
Non specific
Non adaptive
Initiates non-specific inflammatory process
79
This kind of innate immunity does not distinguish between different types of invaders (bacteria, virus, fungi)
Non-specific innate immunity
80
This type of innate immunity does not remember the encounter with specific invaders.
Reacts the same way every time
Non-adaptive innate immunity
81
What is the first line of defense in innate immunity?
Skin and mucosal barriers
82
What is the second line of defense in innate immunity?
Nonspecific inflammatory response to all forms of cell injury or death
83
1st line:
2nd line:
3rd line:
1st line: mechanical barriers (chemical)
2nd line: inflammatory response (phagocytosis)
3rd line: immune response
84
A low or high pH in the stomach kills micro organisms?
Low
85
What are the 5 major types of phagocytes?
```
Neutrophils
Monocytes/macrophages
Eosinophils
Basophils
Lymphocytes
```
86
How long do neutrophils live?
2-3 days
87
How long do monocytes/macrophages live?
Long lived (months or years)
88
How long do eosinophils live?
2-3 days
89
How long to a basophils/mast cells live?
2-3 days
90
Examples of soluble mediators?
The complement system
INFs
Cytokines
91
Internal defense mechanisms of innate immunity cellular/soluble components include:
Phagocytes
Soluble mediators
Natural killer cells
92
These structures eat (via ingesting) micro organisms and kill them to protect the body against infection
Phagocytes
93
These structures engulf and destroy antigens, and die after killing
Neutrophils (PMNs)
94
These structures destroy antigens in the blood stream and mature into macrophages when they migrate into the tissues
Monocytes
95
Neutrophils and monocytes both have receptors sites for antibodies and complement proteins, which enhance what?
Phagocytosis
96
These are also known as "large eaters"
Macrophages
97
These structures clear debris from neutrophils killing bacteria
Macrophages
98
These structures engulf and kill any remaining damaged but not dead antigens, or those that are too large for neutrophils
Macrophages
99
After processing the pathogen, macrophages present the antigen to the helper T cells, T4 lymphocytes, by releasing chemical messenger, ________
Interleukins (IL-1)
100
(IL-1 triggered immune responses)
Increases temp set point in hypothalamus, including _______
Increased serotonin in brain stem and duodenum, causing _________
Increased production of ___________, causing decrease in pain threshold
Increase synthesis of collagenase, causing ____________
Most important response is..... __________
```
Fever
Sleepiness and nausea
Prostaglandins
Destruction of cartilage
Kicking T4 cells into action!!!
```
101
Eosinophils are derived from what?
Bone marrow
102
How do eosinophils kill invaders?
Get within close proximity and release contents of their granules to kill them
103
Basophils are...
WBCs or leukocytes
104
Mast cells derive from
Stem cells
105
Mast cells and basophils circulate in ________
Are responsive to _______
Are located close to ______
Peripheral blood
Allergic disorders
Blood vessels
106
Mast cell releases ______, which dilates blood vessels, causing an increase in blood flow to the area, which increases presence of ________, and optimally decreases presence of bacteria
Histamine
| Phagocytes
107
They neutralize histamine and reduce allergic response
Antihistamine
108
This system is active in innate immune system and adaptive immune system
Complement system
109
How many serum proteins in the complement system? And what are they key components in?
30
| Acute inflammatory response
110
Describe the cascade process of the complement system
Coat microorganism, enhances phagocytosis
Wall off antigens, forming cysts or tubercles
Assists in bacterial lysis
111
(Functions of complement system)
| Activated proteins stimulate _____ causing inflammation and attract _____ and _____ to the area
Mast cells
Neutrophils
Macrophages
112
(Functions of complement system) What is the purpose of complement proteins binding to microorganism and other particles?
Identifying them for destruction by neutrophils and macrophages
113
(Functions of complement system) Complement proteins can also produce _____ in bacterial cell walls causing it to rupture
Holes
114
This small protein acts as a biologic response modifier
Cytokines
115
When are cytokines active?
In acute phase inflammatory reponse
116
Cytokines are secreted by what?
Helper T cells
117
What do the cytokines tell the B cells to do?
Proliferate
118
What acts as a messenger within immune system and between immune system and other body systems?
Cytokines
119
This structure can ramp up or ramp down the immune response
Cytokines
120
When there is an excessive release of cytokines, what does this result in?
Activates excessive amount of T cells and macrophages and additional cytokines
This becomes an uncontrolled reaction
121
Symptoms of a cytokine storm?
High fever
Swelling and redness
Extreme fatigue
Nausea
122
These structures are produced and released by virally infected cells
Interferons
123
There structures coat surrounding cells so they resist viruses
Interferons
124
What do inferferons inhibit?
Tumor growth
125
Large granular lymphocytes
Natural Killer cells
126
There are the most aggressive white cells in immune system
NK cells
127
Where do NK cells mature?
In spleen and blood
128
NK cells respond to signals from ____
Inflammatory cytokines
129
NK cells make up ____ of total lymphocytes circulating in population
5-15%
130
Function of NK cells
Kill viruses, tumors and infectious microbes
131
How do NK cells kill?
By releasing cytotoxic granules and secreting cytokines
132
Acquired specific immunity is a (slow or fast) response?
Slower
133
This immunity takes time to develop after exposure to antigen
Acquired specific immunity
134
___________ immunity is active or passively acquired
Acquired specific immunity
135
What are the primary roles of acquired specific immunity?
Recognize and destroy foreigners
| Prevent reproduction/mass production of mutant cells (malignancy)
136
What is an example of an active acquired specific immunity?
Vaccination
137
What is an example of a passive acquired specific immunity?
Breast milk
138
Acquired immune responses involves the production of _____
Antigen specific B and T cells
139
Immunoglobulin related immunity AKA...
Humoral immunity
140
T cell immunity AKA
Cell mediated immunity
141
Humoral acquired specific immunity produces what?
B lymphocytes
142
This component takes place in body fluids/secretions
Humoral
143
This component of acquired specific immunity deals with infectious agents in blood and tissues
Humoral
144
This component of acquired specific immunity involved antibodies and complement activities
Humoral
145
This component of acquired specific immunity is managed by B cells with help from T cells
Humoral
146
Cell mediated component of acquired immunity produces
T lymphocytes
147
Cell mediated component of acquired immunity deal with body cells that have become infected by doing what?
Invading organisms not accessible by antibodies
148
Cell mediated component of acquired immunity can recognize what?
Hidden organisms
149
Cell mediated component of acquired immunity are managed by what?
T cells
150
Acquired immunity (Humoral immunity=antibody immune response) is mediate by antibodies in
Body fluids, saliva, blood
151
B cells originate and mature where? And how long to they circulate?
Bone marrow
| Up to a year
152
Surface of B cells are coated with
Immunoglobulin
153
Antigen recognition causes activation of two types of protein synthesizing cells, what are they?
Memory B cells and plasma cells
154
There kinds of protein synthesizing cells are responsible for faster, stronger response with repeated exposure to same antigen
Memory B cells
155
If a memory b cell has a reencounter with antigen, it causes differentiation into what kind of cell
Plasma cell
156
This type of protein synthesizing cell is a distinct oval shape and produces large amounts of antibodies
Plasma cells
157
What is the largest immunoglobulin and where is it located?
IgM
| Surface of B cell
158
This immunoglobulin predominates in the initial/early response
IgM
159
This immunoglobulin activates the classical complement pathway
IgM
160
The effector functions of IgM include:
Agglutination and neutralization of foreign invaders
161
The immunoglobulin is the major antiviral and antibacterial antibody in the blood
IgG
162
This immunoglobulin is carried by plasma into tissues
IgG
163
This immunoglobulin confers long term and permanent immunity
IgG
164
This immunoglobulin provides passive protection to newborns, only Ig to cross placenta
IgG
165
This immunoglobulin is promotes phagocytosis and neutralization of pathogens
IgG
166
This immunoglobulin defends external body surfaces
IgA
167
This immunoglobulin is the predominant Ig on mucous membrane surfaces
IgA
168
This immunoglobulin is found in secretions
IgA
169
This immunoglobulin binds to pathogens/prevents adherence colonization
IgA
170
This immunoglobulin has low levels in blood, bound to receptors on mast cells and basophils
IgE
171
This immunoglobulin FUNCTIONS DURING ALLERGIC REACTION-ACTIVATES MAST CELLS
IgE
172
This immunoglobulin releases histamine
IgE
173
This immunoglobulin fights parasitic infections like round worm
IgE
174
This immunoglobulin has low levels in blood, and is the predominant antibody on B lymphocytes
IgD
175
This immunoglobulins primary function is to act as an antigen receptor on mature naive B cells
IgD
176
What are the 4 major functions of immunoglobulin?
1. Attack antigens, destroy or neutralize them (agglutination)
2. Activate complement system
3. Activate anaphylaxis by releasing histamine in tissue and blood
4. Stimulate antibody mediated hypersensitivity
177
The first stage of the humoral system is the...
Activation phase
178
What happens in the activation phase of the humoral system?
Phagocytosis by macrophages, digest infectious agent, display some of its content of their surfaces
179
What is the second stage of the humoral system?
Effector stage
180
What are the main components of the effector stage in the humoral system?
```
Involves communication btw Helper T cells and B cells
Activated Helper T cells
B cells --> memory cells or plasma
Plasma cells
Memory cells
```
181
Where do T cells originate and mature? Then circulate where?
Originate in bone marrow and mature in the Thymus, then circulate in blood lymph and lymph nodes
182
After T cells contact with specific antigen, they produce what?
Sensitized T cells
183
Dendritic cells are the most potent antigen presenter critical for...
Initiating primary immune response
184
List 4 types of sensitized T cells
Helper T cells (CD4+)
Cytotoxic T cells (CD8+)
Memory T cells
Regulatory/Suppresor T cells
185
This T cell is 75% of all T cells
Helper T cells
186
This T cell assists maturing of B cells
Helper T cells
187
What do Helper T cells secrete?
Lymphokines and interferons
188
Which T cell down regulates the adaptive immune response?
Helper T cells
189
Which T cell recognized and destroys virally infected cells?
Cytotoxic T cells
190
Memory T cells will produce what after the recognition of a previous infectious antigen?
Faster secondary immune response
191
This T cell suppresses activation of immune system, preventing autoimmune disease
Regulatory/suppressor T cells
192
What are the 4 T cell functions?
1. Help B cells augment production of antibodies
2. Activate macrophages and help them destroy large bacteria
3. Help cytotoxic T cells recognize and destroy virally infected cells
4. Help NK cells kill infected cells
193
The cell mediated system response involves what two cells?
Cytotoxic T cells or killer T cells
194
What type of cells recognizes infected cells by the foreign matter on other cell's surfaces?
Killer T cells
195
Killer T cells are important in defense against...
Parasites, fungi, other larger cells
196
Killer T cells produce _____ that remember specific antigen or protein
Memory T cells
197
What is the primary response of the cell mediated system?
Initial response to antigens/infectious agents not accessible by antibodies
198
What is the secondary response of the cell mediated system?
Response to an infectious agent/antigens to which the body has formed memory cells
199
What are 4 responsibilities of cell mediated immunity?
Rejected of transplanted tissue
Delayed hypersensitivity reactions
Some autoimmune diseases
Basis for many skin test and allergy testing
200
True or false: Cellular immunity CANNOT be transferred passive to another human
True
201
What can T lymphocyte function by reduced by?
HIV infection and AIDS
202
Conditions that affect number and responsiveness of T cells
```
Stress
Malignancy
Anesthesia
Burns
Surgery
Diabetes
Immunosuppressive drugs
Adults >65
Malnourished
Support systems
```
203
True or false: specific adaptive immunity is present at birth
False. It is NOT present at birth. It is acquired
204
True or false: Specific immunity will develop immediately after initial exposure to a new antigen
False. It will take time to develop. A memory is formed and subsequent responses to a previous encountered antigen are more effective and more rapid than those generated by nonspecific immunity.
205
What is the most important type of white blood cell involved in specific immunity?
Lymphocytes
206
If a pathogen gets past innate immunity, the B lymphocyte may recognize it as ________, and produce antibodies that bind to it and neutralize it, which is what response?
Bacteria
| Humoral response
207
If a pathogen gets past innate immunity, a T lymphocyte recognizes it as ________, cytokines will help macrophages lose and phagocytosis the bacteria, which is what response?
Bacteria
| Cell mediate response
208
If a pathogen gets past innate immunity, in the case of a virus, a_____________ can recognize and destroy it, which is what kind of response?
Cytotoxic T lymphocyte
| Cell mediated response
209
If a pathogen gets past innate immunity, the _________ system can recognize the invading organism and destroy it, which is what kind of immunity?
Complement
| Innate immunity
210
What are the 5 phases of the immune response?
1. Recognition phase
2. Amplification phase
3. Effector phase
4. Termination phase
5. Memory
211
These two types of cells straddle the interfaced of innate and adaptive immunity: this is where communication takes place
T cells
| NK T cells
212
Effects of aging on innate immunity: Exterior defenses (3)
Thinner skin
Weaker bladder
Decreased urine and GI acidity
213
Effects of aging on innate immunity: because pH of urine is not as strong, it may not be able to ....
Kill bacteria
214
Effects of aging on innate immunity: internal defenses (4)
1. Phagocytes: fever in #, decreased function
2. Eosinophils- respond in smaller #, increase parasitic infections
3. Complement proteins- increased in levels produced in liver
4. Decreased interferon production
215
Effects of aging on innate immunity: What does decreased interferon production result in?
Decreased protection against tumors
216
Effects of aging on acquired immunity: Decline in number of what kind of cells?
Naive B and T cells
217
Effects of aging on acquired immunity:
What happens to antibodies?
Decreased antibody production
218
Effects of aging on acquired immunity:
A decreased effectiveness of T cells limits response to what kind of infections?
Viral
219
Effects of aging on acquired immunity: What is the effect on vaccines?
Decreased response and effectiveness
220
For both innate and acquired immunity systems: What are 3 things that happen because of aging?
Decreased resistance to pathogens
Increased indcidence of tumors
Increased autoimmune disorders
221
Factors affecting immune response: (starred in PP)
```
Nutrition
Burns
Decreased sleep
Stress
Anesthesia
Leaky gut
```
222
Iatrogenic factors that increase exposure to pathogens
```
Urinary catheters
Nasogastric tubes
Endotracheal tubes
Chest tubes
Intracranial pressure monitor
External fixation devices
Implanted prosthesis
Sexual practices
```
223
Brisk exercise increases ____ in proportion to effort
WBC
224
Exercise increases _______ and increases phagocytosis activity of _____ and ______
Neutrophils
Neutrophils
Macrophages
225
How many minutes of exercise is optimal for having a positive effect on the immune system?
30 min
226
Negative effects on immune system:
This cell will decrease in number after exercise for 2-4 cells
NK cells
227
Negative effects on immune system: this cell is affected by the TYPE of exericse
Cytokines
228
Negative effects on immune system:
Strenuous exercise can do what to the immune function?
Suppress immune function and damage tissue
229
Negative effects on immune system: are related to these 4 characteristics of exercise
Intensity
Duration
Mass of muscle recruited
Endurance capacity
230
As a PT, we must know that intense/strenuous exercise may...
Harm the immune system
231
If symptoms are above the neck: these include
Stuffy, runny nose, sneezing, scratchy throat
232
If symptoms are above the neck: How should they be exercising to see if they should proceed with normal routine?
Cautiously at half speed for 10 min
If symptoms alleviated, proceed with normal routine
If symptoms worsen, stop.
233
If symptoms are below the neck: this includes what kind of symptoms? Should you exercise?
Fever, aching muscles, hacking cough, diarrhea, vomiting
NO
234
What is the most important variable for IDing immune disorders?
Followed by what?
MEDICAL HISTORY
Followed by red flags in clinical presentation
Assess associated S/S
235
List the 3 classifications of immune disorders
1. Hypersensitivity disorder
2. Immunodeficiency disorder
3. Autoimmune disorder
236
This immune disorder in an increased immune response to presence of an antigen that results in tissue destruction
Hypersensitivity
237
There are three phases of the hypersensitivity immune response: List and explain
1. Immediate hypersensitivity reaction: occurs within minutes of exposure
2. Late phase inflammation: persists hours-days post exposure; can cause cumulative damage (lung disease)
3. Delayed hypersensitivity reaction: sensitization to drugs, chemicals. Reactions take several days to cause Sxs.
238
This is a special class of antigens that case an allergic response
Allergy
239
Allergy refers to...
The abnormal hypersensitivity that occurs when foreign substance introduced into the body
240
This term is used to describe IgE mediated diseases
Atopy
241
Atopy is a genetic disposition to produce large amounts of ______ causing state of _______
IgE
| Hypersensitivity
242
A type 1 allergic reaction is a genetic predisposition with an ____________
Environment association
243
IgE mediated allergic reaction: IgE is produced in response to allergen instead of ____
IgG
244
IgE mediated allergic reaction: IgE produces large innate response (histamine) via _______
Mast cell interaction
245
Classic Sxs of type 1 allergic reactions
```
Wheezing
HypOtension
Swelling
Urticaria (hives)
Rhinorrhea
```
246
Acute type 1 hypersensitive response during anaphylaxis:
```
Systemic vasodilation
Airway inflammation
Bronchospasm
Increase mucous secretion
Edema
```
247
How do you get rid of anaphylaxis?
Epinephrine
248
Epinephrine for anaphylaxis causes: (3)
Acts as bronchodilator
Restores BP
Increased myocardial contractility
249
Epinephrine AKA
Adrenaline
250
Epinephrine is a hormone and neurotransmitter that participates in the fight or flight response or what nervous system?
Sympathetic NS
251
What is the most common cause of anaphylactic shock?
Bee string
252
What is the most common cause of deaths from food allergy?
Peanut allergy
253
Type 2 Cytotoxic reaction to self antigen:
Bodies own tissue is IDed as antigen, so this activates what ______, resulting in ________
Complement system
Results in the body attacking its own cells via agglutination and phagocytosis
254
Type 2 Cytotoxic reaction to self antigen:
Idiopathic
Hemolytic anemia
| Blood transfusion reactions, myasthenia gravis
255
Type 2 Cytotoxic reaction to self antigen: There can be a cross reaction between pathogen and healthy tissue, which can result in ....
Acute Guillian Barre
| Rheumatic Fever
256
Type 3 Immune complex hypersensitivity: What happens?
Large antigen antibody complexes settle in tissues around small blood vessels
257
Type 3 immune complex hypersensitivity
What does the pathology depend on?
Site of deposition
258
Type 3 immune complex hypersensitivity
Complement reaction cascade activated by complexes causing:
Acute inflammation
Vasculitis
Local tissue injury
259
Type 4 cell mediated hypersensitivity reaction
Describe the delayed response
T cells are sensitized then response occurs in 48-72 hours
260
Type 4 cell mediated hypersensitivity reaction: Graft vs host example
Disease transplant cells attack host (bone marrow transplant)
261
Type 4 cell mediated hypersensitivity reaction
Host vs graft example
Transplant rejection (body rejects liver)
262
Type 4 cell mediated hypersensitivity reaction
Contact dermatitis
Latex
Adhesive
TB skin test
263
A primary deficiency in immune-deficiency disease is a genetic defect of what?
T cells
B cells
Lymphoid tissue
264
Primary or secondary deficiencies have greater than 95 inherited IMD diseases IDed?
Primary
265
Primary deficiencies causes 3 things...
Increased susceptibility to cancer
Autoimmunity
Infection
266
Secondary deficiency for IMD diseases are caused by what?
Underlying disease or factors that depress/block immune response
267
Examples of secondary IMD diseases
```
Hodgkins lymphoma
DM
CA
Infections
HIV/AIDs
```
268
Iatrogenic IMD diseases include:
Cortico steroids
Radiation
Chemotherapy
269
HIV disease is an infection of what system?
The immune system
270
Advanced HIV is known as..
AIDS
271
Viral cause of AIDS IDed in what year
1983
272
What are the two types of HIV and where are they located?
HIV 1- US
| HIV 2- Mainly west african countries
273
AIDS- characterized by progressive destruction of ___________ (what kind of immunity)
Via destruction of _______ (what kind of cells)
Cell mediated immunity
T4 Lymphocytes
274
AIDS- There are changes in humoral immunity and autoimmunity secondary to decreased number of what?
CD4+ T lymphocytes (HELPER T CELLS
275
Who is at highest risk for AIDS
Homosexual men
Sex workers
IV drug users
Unprotected sex
276
When you have HIV 1 plus: your CD4+ T count is what?
< 200/ml
277
When you have HIV 1 Plus:
You have less than ___% of CD4"CD* ratio
15%
278
What are the 4 phases of clinical manifestations for AIDS (list)
Acute
Asymptomatic
Symptomatic
AIDS
279
During the acute stage of HIV...
1-6 weeks of flu like Sx
| Antibody test usually negative until seroconversion
280
During the asymptomatic stage of HIV, there is a...
Positive antibody test
| Generalized fatigue and lymphadenopathy
281
During the symptomatic stage of HIV, there is...
```
Persistent adenopathy
Neurologic Sxs
Weight loss
Night sweats
Fever
Fatigue
```
282
During the advanced HIV disease (AIDS) stage,
What is the level of lymphocytes
And other Sxs...
Lymphocytes are extremely low...
Kaposi's sarcoma
HIV dementia
Poly neuropathy - pain
283
AIDS associated diseases include...
```
Neuromuscular diseases
Rheumatologic diseases
IRIS (immune reconstitution inflammatory syndrome)
Lipdystrophic syndrome
AIDS
Cardiopulmonary diseases
```
284
This syndrome involves defective fat metabolism, insulin resistance, central fat accumulation
Lipodystrophic syndrome
285
During the early stage of exercise for people with HIV...
Is it safe?
Yes
286
During the early stage of HIV, exercise will cause an increase in...
Increase in CD4 cells - may delay symptom progression
Increase muscle size and strength
287
During the advanced chronic stages of HIV, exercise is more ______. _____ forms are NOT recommended. What is required?
Difficult
Strenuous
Medical clearance required
288
During all stages of HIV, exercise may provide
Pain relief
| Cardiovascular and pulmonary function
289
CFS is..
Chronic Fatigue Syndrome
290
What is chronic fatigue syndrome?
Unexplained fatigue greater than 6 months with 4 of the following symptoms:
```
Sore throat
Tender lymph nodes
Muscle pain
Arthralgia
Headaches
Poor sleep
STM deficits
```
291
Etiology of CFS
Parts of immune system are abnormal
292
Tx for CFS
Variety of meds:
| Growth hormone, pain meds
293
PT for CFS
Graded exercise, posture reeducation, soft tissue mobs, aquatic therapy
Monitor vital signs with TE
294
What is the definition of autoimmunity
Failure of an organism to recognize its own constituent parts as self, which allows an immune response against its own cells and tissues
295
What happens to the immune system with an autoimmune disease?
It becomes self directed
296
What is the etiology of autoimmune diseases
Unknown
| Acquired, via a combo of factors (environment, hormones, genetics)
297
Must have what triage for the development of an autoimmune disease?
Environmental
Hormonal
Genetic
298
Pathogenesis of autoimmune disease: 4 hypotheses
1. Antibodies that cross react with normal tissue
2. Depression of suppressor T cell activity
3. Role of leaky gut
4. Ultra sensitive immune systems
299
Production of autoantibodies occur in what kind of diseases?
Autoimmune diseases
300
Commonalities of autoimmune diseases
```
Synovitis
Pleuritis
Nephritis
Myocarditis
Skin rashes
Changes in CT and constitutional Sxs
```
301
What is a major difficulty with autoimmune Dx?
Patients and clients may look fine but many systems are affected
302
Tx or autoimmune diseases
Corticosteroids- inflammation
| Salicuclates- symptomatic relief
303
Is there a vaccine for autoimmune diseases?
There is one that is developing
304
Common constitutional symptoms of autoimmune diseases
Fatigue
Malaise
Myalgia
Arthralgia
305
What does humoral mediated therapy consist of?
Removal of antibodies that are attacking pt's own tissue
306
Cellular mediated therapy consists of:
Biological drugs
| Cytotoxic therapy
307
Systemic lupus errythematosus (SLE) is a chronic inflammatory disorder affecting the...
Skin- face, neck, scalp (Discoid lupus)
Or
Organ/system of body (SLE)
308
SLE involved production of antibodies against...
```
RBCs
Antibodies against RBCs
Neutrophils
Platelets
Lymphocytes
Any organ
```
309
Almost everyone with SLE has...
Joint pain and swelling
310
A skin rash "butterfly shape" is most often seen over the cheeks and bridge of the nose. Gets worse in the sunlight.... can be seen in what disease?
Systemic Lupus Erythematosus
311
If you have headaches, numbness, tingling, vision problems, etc... what system may be affected?
Brain and NS
312
If you have abdominal pain, nausea, and vomiting, what may be affected?
Digestive tract
313
If you have abnormal heart rhythms and endocarditis, what might be affected?
The hear
314
If you are coughing up blood and have trouble breathing, what might be affected?
Lungs
315
If you have a patchy skin color, and fingers that change color when cold, what might be affected?
Skin
316
If you only have lupus symptoms in the skin it is called...
Discoid lupus
317
Tx of SLE
Anti inflammatory agents
Steroids
Immunosuppressive drugs
318
PT for SLE
```
Pace activities
Conserve energy
AVOID BED REST
Protect joints
Strengthen muscles and improve endurance
```
319
Fibromyalgia syndrome (FMS) is a SYSTEMIC syndrome with widespread multi tender points defined as....
Chronic widespread pain with allodynia or hyperalgesia to pressure pain
320
What is the most common MS disorder in the US?
FMS
321
FMS affects who more?
Women, ages 20-55
322
Sxs of fibromyalgia
```
Muscle pain
Sleep problems
Breathing problems
Digestive problems
Symptoms increase with humidity, cold
Exacerbated with stress
```
323
Dx of fibromyalgia
Thru process of elimination, PMH
324
Tx for fibromyalgia
Stress management
Meds
Modalities
Aerobic ex
325
What function is affected in FMS?
Diaphragm function
326
Risk factors for FMS
```
Anxiety
Minimally to moderately fit persons
PTSD
Bipolar
Silicone implants
Depression
```
327
True or false: Etiology is unknown for FMS
True
328
RA is a chronic, systemic, inflammatory disease resulting in destruction of what?
Joint tissue
329
RA involves cell mediated and humoral responses. The etiology is:
Massive infiltration of T lymphocytes in synovial fluid
Genetics
Environmental triggers
330
Who is more likely to develop RA?
Females > males
| 3:1, 30-60 years old
331
Class 1 RA
Completely able to perform usually ADLs
332
Class 2 RA
Able to perform self care and vocation activities, limited in a vocational activities
333
Class 3 RA
Able to perform usual self care, limited in vocational and avocational activities
334
Class 4 RA
Limited in ability to perform usual self care, vocational and avocation activities
335
General RA Signs and Symptoms
```
Joint stiffness and pain
Fatigue
Weakness
Bony erosions
Nodules
```
336
What happens to the joint space in RA?
It is narrowed
337
Explain the gel phenomenon of RA
Stiffness is relieve with activity, recurs after person sits down and then attempts to resume activity
Stiffness is again present
338
RA tends to involve joints asymmetrically or symmetrically?
Symmetrically
339
Innate immunity is a ______ interaction with different antigens; lacks immunological memory
NONSPECIFIC
340
Humoral (adaptive) immunity has a ______ interaction with different antigens
SPECIFIC
341
Cell mediated (adaptive) immunity has _______ interaction with different antigens
SPECIFIC
342
What is the only intervention that is beneficial for CFS?
Graded exercise therapy
